Provider Demographics
NPI:1073646345
Name:DUKE, LELA J (BS, PT)
Entity Type:Individual
Prefix:MS
First Name:LELA
Middle Name:J
Last Name:DUKE
Suffix:
Gender:F
Credentials:BS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3063 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-8356
Mailing Address - Country:US
Mailing Address - Phone:828-437-9492
Mailing Address - Fax:
Practice Address - Street 1:145 W PARKER RD
Practice Address - Street 2:STE A
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4628
Practice Address - Country:US
Practice Address - Phone:828-433-5171
Practice Address - Fax:828-433-1127
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC079NVOtherBCBS